| NPI | 1861020752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KY 10411) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 10411) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: KY 10411) | |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2022-09-02 |